Behavioral Health Quality Assurance Reporting Requirements (QARR)

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Presentation transcript:

Behavioral Health Quality Assurance Reporting Requirements (QARR) OMH Quality Improvement Projects & PSYCKES Data Anni Kramer & Erica Van De Wal PSYCKES / Bureau of Evidence Based Practices and Implementation Science NYS Office of Mental Health PSYCKES-help@omh.ny.gov

QARR Overview The National Committee for Quality Assurance (NCQA) Accredits Managed Care Plans Develops the HEDIS quality measures CMS & States have adopted HEDIS measures New York State DOH’s selects a QARR subset Behavioral Health QARR: 12 of 74 Child Behavioral Health QARR: 7 of 12 Managed Care Plans are required to report on QARR measures yearly DOH selects a subset of QARR measures for Quality Incentives 5 of these are specific to Behavioral Health 2 of these are child measures

BH QARR Measure * Follow-up after MH hospitalization Quality Incentive Child Measure Adult Measure Follow-up after MH hospitalization * Follow-up with prescriber after new ADHD prescription Antipsychotic medication adherence (clients w/ schizophrenia) Antidepressant medication adherence Diabetes monitoring (clients w/ diabetes and schizophrenia) Diabetes screening (clients w/schizophrenia or bipolar disorder using antipsychotics) Cardiovascular monitoring (clients w/ schizophrenia and cardiovascular disease) Substance use treatment initiation and engagement Utilization of PHQ-9 to monitor Depression/Suicide Antipsychotic polypharmacy Metabolic monitoring (clients on antipsychotics) Psychosocial services prior to starting antipsychotics

OMH QARR Quality Improvement Project Goal: to promote provider awareness of and performance on QARR measures Measures: current BH QARR Quality Incentive measures Participating Programs: 94 free-standing Clinics & FQHCs Project Activities: Project Launch Webinars Sept-Oct 2016 Clinic self-assessment & plan for improvement Monthly learning collaborative calls Monthly QI reporting on progress Review performance using PSYCKES data

PSYCKES Overview PSYCKES is a secure, HIPAA-compliant web-based platform for clinical decision making and quality improvement Includes Medicaid FFS claims and Managed Care encounter data Over 6 million NYS Medicaid enrollees All treatment settings Integrates other state health databases CAIRS, NIMRS, TACT, DOH HH/CM, and State PC EHRs Clinical Summary provides up to 5 years of data, updated weekly Quality measures updated monthly Any provider agency staff can gain access

Using PSYCKES: QI Indicator Sets

Using PSYCKES: Recipient Search

Using PSYCKES: Clinical Summaries

Using PSYCKES: Clinical Summaries